A very satifying three months….

I’m back home with the unrealistic expectation that spring would greet me!  RIGHT!  April 14 and it is snowing! 

As consolation for the grey and cold, I will visit the work and faces from my time at FAME.  With that comes the lush green of the landscape, the beautiful colors worn by the African women and the warm smiles that light up every face.

First the endearments – I’m known as DEanEE, Professor, grandma, or Bibi.  This was my first time there with white hair, hence the last two.   But the most endearing was shikamoo.  Thabit, our head of security, greeted me with it often and brought to my attention it’s meaning.  I noticed strangers greeting me this way.  It included teenage boys on the streets in Karatu and an immigration officer who turned from stern to a smiley fist bump with shikamoo,once he saw my hair.  Thabit taught me that this lovely term means “I give you my respect” and you then respond with marahaba “I accept your respect”.    We should adopt this here!

My white hair earned me many wonderful moments, like these kids who traded me taking some cool photos of them for touching the straight white stuff on my head.

I will pepper photos and stories of some of the people while others have appeared in my earlier blogs. I will miss many, but certainly not because they aren’t an important part of my Tanzanian family.  Over the years the trust and friendships have deepened to a very satisfying place.  It was an important launch for the three months of work we had ahead.

How do I begin with the work?  What makes sense is to break this into a couple of parts.  First, I’ll cover the work on the 2022 – 2027 Strategic Plan (SP).  Then move on to developing work plans and communicating the strategic priorities to all staff. 

A friend asked if I knew what I was going to do before I left.  “NO” I just went with a suitcase of colored post it notes, a box of sharpies, markers for the white boards (that I installed my first year there) and a robust sense of humor!   My main goal was to fully engage everyone in meeting outcomes.  It worked.  At the end when they celebrated my time there.  I could honestly say “none of these fabulous ideas were mine”!  I’m most proud of that. 

I first sent them away in unlikely couplings that maximized creative brainstorming around a set of questions. We then came back together to consolidate the ideas and prioritize for those ideas that should focus FAME resources over the next five years. 

I believe this approach will be used long after I’m gone.  Anthony, running one of the best labs in Tanzania, likes to say when he sees me “brainstorm, consolidate, prioritize”.  He also told me that his family is doing a SP. 

Gabriel, our lead doctor, said “we never waste time in your meetings”.  That was good to hear because the next set of meetings, to build out the workplan for each of the five strategic priorities, meant that managers and supervisors saw a lot of me over my three months there.

In meetings, humor was always the special guest!  Once I suggested more whiteboards.  William said “if it was up to you we would have one in every room and I’m putting a stop to having them in the toilets”.  The room started in on brainstorming the productivity advantages to whiteboards in the toilets!  I have always said FAME toilets are so clean you could eat lunch in them so it spun out from there.  Having 12 siblings taught me the value of fun with a touch of chaos AND when to rein it in.

Ok, back to the work!  Once the strategic priorities were approved by the board, we convened a team of involved department heads and supervisors to determine activities and resources needed to advance each priority – the workplans. 

Simultaneously, each department had a LOOKUP session.  These were based on the notion that success comes from alignment.  It comes when each member of an organization is focused on doing a specific job but when they look up they see the same thing.  This includes FAME‘s timeless mission, vision and values followed by the next five year’s strategic priorities.  We then did an activity – yes with colored post its and sharpies – around a set of questions.  What skills, knowledge, resources, etc. do you in your department (kitchen, housekeeping, reception, doctors, lab, pharmacy, etc.) need to advance these priorities?  Appreciation, for knowing the direction and the opportunity to provide input, was expressed across the board.  The sessions gave me a chance to remind each department how critical they are to all that FAME achieves. 

My head spins when I think about pulling out just one example.  But suffice it to say, “those spotless toilets are not the only place clean enough to eat lunch”.  Daily, floor too ceiling, cleanliness through out the hospital happened without hesitation. That included my house where Veronica and EVA spoiled me!

The folks in reception are hired from the hospitality industry and it shows.  Their warm welcome is part of the healing!

Medical records has their very own priority ushering in data collection and analysis to support all aspects of patient care, administration, and accountability to funders.  

One of the strategic priorities is Plan for the Unexpected to ensure that the lessons from Covid inform future adverse events.  Each department met with nurse Anne’s husband Don, an engineer from Iowa who joined us for the last five weeks.  Thankfully he was eager to take on this big project with engineering precision!  I attended as many as I could and received the notes from all.  It broke my heart to hear of the challenges that covid presented to a limited resource environment with a government who did not allow using the word “covid”! 

It was clear that the mission of “patient centered care”, was the driver of amazing creativity and resilience.  At the core was the approach to communication, particularly considering the government restrictions.  Following the guidance of the CDC and WHO, staff developed a framework for internal protective processes and proceeds.  All departments adopted the framework and spread it to the broader community through family, friends, churches, and other community organizations. When a patient was sent home to recover their family was taught how to care for them and protect the family.  They also educated other hospitals on their approach.

Pharmacy lead by smarty Egbert, developed the internal production of cleaning solution, significantly reducing plastic bottle waste and cleaning supply costs. 

https://hyposource.com/blogs/stories-from-the-field/fame-tanzania-hospital

Kitchen changed from buffet to serving lunches and moved tables outside for social distancing and fresh air.  Handwashing stations are everywhere and will stay.  So many more examples demonstrate what happens when resourcefulness becomes a substitute for resources.

I’ll miss the best group of doctors and nurses on the planet. It was so great to see my old friends who have been there since my first trip and will never let me live down the jamba mishap. And the many new medical staff who are wonderful additions to the energy at FAME.

I can’t do this blog without a nod to many important sidekicks. 

AND my very smart and capable “Mini-Me” Prosper.  He will ensure follow through on all of the important decisions.  I would have been lost without him!

The three months was packed with opportunities, laughter and learning for me.  The commitment to learn and grow at FAME is beyond cool and I’m so proud to be part of it!